Provider Demographics
NPI:1255301115
Name:GODWIN, FRANKIE J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:FRANKIE
Middle Name:J
Last Name:GODWIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 TOWN PLAZA CT
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6206
Mailing Address - Country:US
Mailing Address - Phone:407-695-3664
Mailing Address - Fax:407-695-3674
Practice Address - Street 1:1806 TOWN PLAZA CT
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-6206
Practice Address - Country:US
Practice Address - Phone:407-695-3664
Practice Address - Fax:407-695-3674
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5312103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS27767Medicare UPIN
FL59798ZMedicare ID - Type Unspecified